The rural communities of the upper Midwest and Central Plains represent a large underserved population for cancer treatment, care delivery and clinical trials. The causes of this difference are multi-factorial but a main obstacle is access to services in rural regional areas. Sanford Health has developed a network of hospitals, cancer centers and clinics to provide high quality multi-disciplinary cancer treatment, clinical trials, ad cancer care delivery to this underserved area. It is hypothesized that this disparity in care for this rural population can be improved by utilizing the organized Sanford Community Cancer Program (SCCP) network community. This proposal describes the NCI NCORP partnership to help deliver clinical trials and cancer care delivery across the rural area the SCCP serves. This will be accomplished through the following aims: 1. /Maintain and enhance robust accrual to NCI Division of Cancer Prevention (DCP) supported clinical trials through our five primary components. 2. Address disparities in clinical trial accrual in underserved and underrepresented populations to increase participation. 3. Cultivate Innovative access points to address barriers to clinical trial accrual through outreach and telemedicine. 4. Develop a Cancer Care Delivery infrastructure. Through these four aims the Sanford Community Cancer Program will transform implementation of state of the art clinical trials, cancer treatment and cancer care delivery to approximately two million people across parts of five states living in rura America. Many of these people are more than 2 hours from the nearest community cancer center, a situation complicated by 4 to 6 months of harsh weather, which can make travel unpredictable and often dangerous. The ability to provide cancer care, including clinical trials, through outreach and telemedicine to this underserved rural population in their local communities ensures timely, optimal treatment and improved outcomes.